Published online Jul 6, 2020. doi: 10.12998/wjcc.v8.i13.2870
Peer-review started: March 2, 2020
First decision: April 7, 2020
Revised: May 7, 2020
Accepted: June 13, 2020
Article in press: June 13, 2020
Published online: July 6, 2020
Patients undergoing liver transplantation can develop posterior reversible encephalopathy syndrome (PRES) and acute heart failure (HF) in the post-operative period. But PRES with HF caused by tacrolimus has rarely been described.
A 40-year-old female patient who had a normal preoperative cardiac and neural evaluation developed PRES with acute heart failure tacrolimus-induced after liver transplantation. The challenges associated with both diagnosis and management in the setting of a newly implanted graft are discussed.
Tacrolimus can induce neurotoxicity and then cardiac toxicity. Magnetic resonance imaging, echocardiography, and increased brain natriuretic peptide may be predictive of post-operative PRES with acute heart failure. Further investigations are necessary to verify this finding.
Core tip: We describe a case of tacrolimus-induced posterior reversible encephalopathy syndrome with acute heart failure, which developed after liver transplantation in a patient who had a normal preoperative cardiac evaluation.